| NPI | 1427589654 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MT MED-PHYS-LIC-176398) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VT 042.0015687) |
| 207L00000X Anesthesiology (Licence: OR MD215777) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2026-09-25 |